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Addressing the Issue of a Chemically Impaired Nurse

A nurse with a chemical dependence might seem to be a rather low-probability issue in the nursing setting, yet a closer analysis of the current situation, particularly, in the community under discussion, will show that the threat in question is quite possible. According to the 2021 statistics, it is currently presumed that at least 15% of the total number of healthcare experts in Florida suffer from some form of chemical impairment of varying severity (Toney-Butler & Siela, 2021). Therefore, the observed case, while being an understandably upsetting instance of violating the law and the foundations of healthcare ethics, should be regarded as a symptom of a larger issue within the current Florida healthcare and nursing community. The purpose of this paper is to consider the issue at hand critically and create a strategy that will allow assisting nurses with chemical dependency, as well as minimize the threat of medical errors caused by the specified demographic.

Therefore, the concern under analysis can be regarded as a twofold problem. Apart from the obvious instance of theft, namely, the fact that the nurse has been taking drugs intended of patients from the unit, one should also point to the fact of drug misuse in the workplace setting. For this reason, two legal policies must be incorporated into the analysis. Specifically, chapter 812 has been violated in the described situation. According to the legal standards currently functioning in Florida, chapter 812 states that theft implies that “A person commits theft if he or she knowingly obtains or uses, or endeavors to obtain or to use, the property of another with intent to, either temporarily or permanently” (The Florida Senate, 2018, para. 1). Therefore, the case at hand is a clear violation of chapter 812 since the nurse has stolen the drugs that belong to the hospital and must be used to address the health needs of patients. In turn, from the ethical and administrative perspectives, the observed situation represents a violation of the Florida Nurse Practice Act (NPA) (Toney-Butler & Siela, 2021).

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Steps

To address the issue of theft due to drug misuse, an administrator nurse will have to conduct an investigation by considering the evidence that points to the theft and the presence of the chemical impairment in the suspected nurse. If the issue is confirmed to be true, an administrator nurse must report the issue to the supervisor, who will take further actions to manage the problem on a legal level (Cameron, 2017). Finally, the plan for assisting the nurse in question in managing the chemical impairment and undergoing rehabilitation must be drafted.

Recovery Program

When addressing the problem of substance dependency in nurses, it is important to remember that criminalizing people with a chemical impairment is unlikely to lead to an improvement in the observed situation. Specifically, studies have shown that the attempts at making the standards for sentencing people with drug misuse issues harsher have led to even more drastic outcomes, causing people to avoid seeking help when developing a substance misuse e disorder (Cameron et al., 2018). Combined with the social stigma, the specified factor will lead to no tangible improvements (Cameron et al., 2018). Therefore, a recovery program is needed to support nurses with chemical dependency and promote rehabilitation as the main method of managing the issue.

The proposed program will consist of three key steps. Building awareness and offering anonymous consultations for nurses that have been struggling with drug misuse issues should be seen as the main strategy for increasing the rates of successfully managed cases. The second step will require introducing a combination of drug therapy and cognitive behavior therapy (CBT) coupled with counseling, which will help nurses with a chemical impairment to change their attitude toward the problem and shape their behavior accordingly. Specifically, the priorities will be shifted toward developing the tools for managing the addiction and rejecting the actions that will entail legal and disciplinary repercussions for nurses with a chemical impairment, as well as entail ethical repercussions.

Moreover, the focus on peer assistance should be treated as a vital step in the development of the program. For this purpose, the principles of the Transformational Leadership framework will be implemented to shape nurses’ attitudes toward healthcare staff with chemical dependency issues so that the pressure of the social stigma should not affect the target population from seeking help. Instead, nurses will be encouraged to offer support and assistance to their peers that suffer from a chemical impairment.

The fourth step will involve the introduction of treatment options. Specifically, the biopsychological method of treatment will be deployed to combine the CBT technique mentioned above with medications, particularly, the withdrawal and detoxication with the following prevention of relapse. The first stage will require the use of medications such as lofexidine, which will cause a nurse with a chemical impairment to experience a drop in the extent of craving for substances (Higan et al., 2018). In turn, the stage of controlling the withdrawal will suggest introducing a minimal dose of opioids to sustain the nurse while the process of developing new behaviors and, particularly, resilience, are developed.

Finally, the ethical aspect of the therapy must be addressed. Specifically, the nurse will be provided with guidance and transformational leadership that will lead to a change in perceptions of the nurse’s role and responsibilities in the workplace. Specifically, the importance of beneficence and non-maleficence, which are violated once a theft is committed, will be reinforced as the foundational notions of nursing care. Thus, a drastic behavioral change is expected as a result, signifying successful rehabilitation and the chance for a nurse to return to performing the key workplace tasks.

Healthcare Quality

The program described above will contribute significantly to the improvement in the quality of healthcare. Specifically, since the program will allow identifying instances of chemical impairments in nurses more effectively and extending help to the target population immediately, the probability of these nurses affecting the quality of nursing services and making medical errors as a result of their substance misuse will be minimized. Specifically, after being detoxified and provided with the required therapy, nurses will be withdrawn from the environment in which the changes in their behaviors and skills caused by substances may affect the well-being of patients. At the same time, the nurses with chemical impairments will not be fully rejected from the nursing setting but, instead, will be provided with a chance at rehabilitation.

It is believed that the approach described above will prove to be successful since it prioritizes rehabilitation over punishment. Moreover, the proposed strategy is related directly to the Person-Centered Nursing Leadership Framework by McCance and McCormack (2016). Implying that therapeutic caring should become the foundation of managing patients’ needs, the specified model requires that recovery and the further support of patients should be viewed as the ultimate goal. In turn, the program described above focuses on addressing the chemical dependency that the target population develops and offers tools for overcoming it and being integrated back into the community and workplace.

References

Cameron, C. (2017). The strategic and legal risks of work-integrated learning: An enterprise risk management perspective. Asia-Pacific Journal of Cooperative Education, 18(3), 243-256.

Cameron, C., Freudenberg, B., Giddings, J., & Klopper, C. (2018). The program risks of work-integrated learning: A study of Australian university lawyers. Journal of Higher Education Policy and Management, 40(1), 67-80. Web.